Top diet researchers reveal what it really takes

Pride. A sense of mischief. Or the need to remember just how far her diets and weight loss have come. Every once in a while, something inspires hairdresser Karen Brown, 39, to line up her "before" pictures beside her scissors, combs, and blow-dryer at the Vermillion Hair Salon in Centennial, CO.

"When I was 29, I weighed nearly 195 pounds—and I'm only 5 feet 3 inches tall," says Brown, who is now a svelte 124. "I have four kids, and with each pregnancy I gained another 20 pounds that never came off. I wore those baggy, no-size clothes all the time. And I tried everything: the grapefruit diet, the Hollywood diet, the stewardess diet, the cabbage soup diet, diet shakes. Nothing worked."

For this survivor of the diets war, the answer was do-it-yourself—a crazy quilt of strategies custom-fit to her personality. "I worked out for an hour and a half five days a week with a friend. I reduced calories but didn't restrict my food choices. No food was off-limits; I just kept portion sizes in check. And I made it a very positive thing: What can I have today, what can I do today, what can I be today? That's what I told myself."

Brown's experiences and insights track perfectly with weight loss research findings from the past year or two that have turned nearly everything we thought we knew about what really works—and why—on its head. "All diets work," Brown says. "Whether you can maintain after you've reached your goal is another story. If not, you've got to wonder if it's the right thing."

Not too long ago, the idea that Brown could eat anything she wanted and still lose weight would've had weight loss experts guffawing. The "proper diet" was hotly debated by advocates of the low-carb, high-protein Atkins diet; the low-fat, high-carb American Heart Association diet; and other versions of these diets. "There was a war coming from the low-fat side," says psychologist Thomas A. Wadden, PhD, director of the Weight and Eating Disorders Program at the University of Pennsylvania. "Atkins felt denigrated and misunderstood."

Now the dust has settled. Major studies have left many weight loss experts surprised and chagrined. For those scoring at home, the research revealed that all the diets deliver about the same amount of weight loss, and no single plan was significantly more healthy—or unhealthy—than the rest.

Winning your diet warBut there's more to report. Cutting-edge diet research is full of hope and creative solutions for the most intractable weight loss dilemmas, from a simple way to fill up for 800 fewer calories a day to a food formula that sidesteps the metabolic slump that dooms many diets. One amazing study even suggests that eating the right foods could cut your weight by 10 pounds or more in a year—without dieting.

But just as not all calories are created equal, neither are all dieters. As Karen Brown discovered, weight loss finally works when it fits your personality, your lifestyle, and your taste in food. That's why we've presented these new weight loss success strategies cafeteria-style—so you can pick and choose to create your own perfect plan.

[pagebreak]

Feel full on less

Several new studies show that choosing "smart calories" gives you a definite weight loss advantage. These foods won't erase the excesses of a Big Mac and large fries, but they could help you stay on the weight loss path. "We're seeing suggestions that maybe not all diets work the same," says Gary Foster, PhD, clinical director of the University of Pennsylvania's Weight and Eating Disorders Program. "By choosing different types of carbs, fats, and protein—and the proportions of each—you can get different effects." Three intelligent calorie strategies:

Eat nuts, lose more weight. When 52 overweight women and men followed a 1,000-calories-a-day diet for 24 weeks, those who ate almonds at meals and snack time lost 18% of their body weight, while those whose treats were carbohydrate-based (wheat crackers, baked potato, air-popped popcorn) lost just 11%. The nut eaters whittled their waists by 14%; the carb snackers, 9%. Researchers from the City of Hope National Medical Center in Duarte, CA, suspect that the protein, fat, and fiber in almonds keep you feeling full longe—and that not all the calories in almonds are absorbed thanks to the tough cell walls of these nuts.

Try this: Walnuts, pecans, unsalted peanuts, and other nuts should have similar effects—they're packed with fiber and good fats, too. Have a handful (no more—they're also high in calories) in place of your usual midmorning or afternoon snack.

Fool your stomach. Pennsylvania State University nutrition expert Barbara Rolls, PhD, found in one ingenious study that secretly reducing the calorie density of food—by preparing mac and cheese with less butter and cheese, for example, or adding more veggies and less cheese to pizza—cut 544 calories a day from the diets of 24 young women ages 19 to 35, and they never noticed the difference. Trimming portions sliced away an additional 256 calories a day. "Saving 800 calories a day is enormous," says Rolls, author of the book The Volumetrics Eating Plan.

"We eat roughly the same volume of food every day or so," she says. "If you can reduce the calories by focusing on water-dense fruits and vegetables, you can keep the volume high and feel satisfied. Your stomach senses food volume—it has stretch receptors and pressure sensors."

Try this: Start meals with a big salad--lots of veggies, no croutons or creamy dressing; have double portions of fruit and veggies at meals and skip or cut back on calorie-dense starches, fats, and fatty meats. Opt for a fruit dessert, with a dab of sorbet or ice cream for flavor.

Eat eggs for breakfast. Women who started the day with two eggs and toast felt so much fuller and more satisfied than those who had a bagel and cream cheese that they ate 274 fewer calories the rest of the day, finds a study from the Rochester Center for Obesity Research in Michigan. The egg group even ate fewer calories the following day. Protein-rich eggs, say the researchers, are simply more satisfying than breads and bagels.

Try this: If you don't have time to scramble eggs on weekday mornings, hard-boil a few on Sunday and keep 'em up to a week in the fridge for quick, on-the-move breakfasts.

[pagebreak]

Save your metabolism

Dieting's cruelest truth: As you cut calories, your metabolism downshifts in an effort to hold on to fat. "The body simply can't tell the difference between purposeful dieting and starvation," Wadden notes. Grim, but by choosing the right food for your diets, you can preserve that calorie-burning mechanism.

Burn more calories with quality carbs. Swap the pastrami on white bread for turkey and avocado on whole grain: Research from Children's Hospital, Boston, and Brigham & Women's Hospital suggests that good fats and high-fiber carbohydrates could outsmart a metabolic slowdown.

Researchers studied 39 overweight and obese dieters ages 18 to 40 who noshed on a low-glycemic ("good-carb") or low-fat diets for 10 weeks. Each plan clocked in at 1,500 calories and each volunteer eventually had about 20 pounds of weight loss, but that's where the similarities ended. Low-glycemic dieters maintained a metabolic rate—the number of calories your body burns at rest—80 calories per day higher than the low-fat group. Over the course of a year, that could translate into the loss of an extra 8 pounds. The low-glycemic group also felt less hungry and had lower levels of heart-threatening triglycerides and C-reactive protein, an inflammatory compound associated with heart attack risk.

"The idea with low-glycemic eating is that blood sugar stays lower, you feel full faster, and the body doesn't seem to react to the diet with as much stress," says researcher David Ludwig, MD, director of the obesity program at Children's Hospital, Boston. "People feel less hungry, their metabolic rate stays a little higher, and they feel better—they'll be more likely to get up, turn off the TV, and exercise."

Even more surprising: Choosing those good carbs—fruits, veggies, and whole grains—over the refined stuff (sodas, doughnuts, even white potatoes) could help keep you from gaining 10 extra pounds even if you don't cut calories, research from the University of Massachusetts Medical School suggests. Scientists followed the eating habits, exercise levels, and body weight of 572 women and men for 1 year, ranking their food choices by how much they raised blood sugar, a system called the glycemic index (GI). (Refined and starchy carbs are high on the GI because they raise blood sugar higher and faster than foods with a low GI.) Their findings: Body weight increased 9.6 pounds more for every 10-point increase in the total glycemic index of a person's daily diet. That could be the difference between choosing a baked white potato (with a GI of 85) instead of broccoli (with a GI of nearly 0).

"Nearly 10 pounds is a significant difference," says Barbara Olendzki, RD, MPH, an instructor of medicine at the school. "If people can lower the GI of their diet by choosing the best carbohydrates to eat, they should be able to lose some weight. Because they're more filling, lower-GI foods can also be helpful for appetite control."

Try this: Be sure you're subtracting high-glycemic foods when you add low-glycemic options. Say no to that blueberry muffin; have the banana and milk. Say yes to a handful of almonds; banish the chips. Love baked potatoes? Go with a sweet potato (with a GI of 54) instead of a white potato.

"Eat an abundance of fruits, vegetables, and legumes," Ludwig advises. "Grain products should be as whole as possible and served as a side dish, not the main meal. Fats can be consumed liberally as long as they're healthful-olive oil, avocado, nuts, fish (for the omega-3 fatty acids). Have an adequate amount of protein."

Exercise and maintain your muscles. Exercise is a no-brainer strategy for losing and maintaining weight, and for cutting your heart disease risk, Wadden says. The proof? Among the many studies showing a direct link between a lower body mass index (BMI) and more time spent exercising, University of Pittsburgh researchers found recently that dieting women who exercised 5 days a week for 50 to 60 minutes each time lost 15% of their body weight—a whopping 23 pounds, on average—in just 6 months. Those who kept it up maintained their new trimmer silhouettes for the next 6 months.

But the biggest reason to exercise is the health benefits, Wadden says. "Researchers at the Cooper Institute have found that it reduces heart attack risk even if you're overweight. And as you get older, strength training will help prevent the natural loss of muscle density and the drop in metabolic rate."

Try this: In addition to your regular aerobic exercise (which you're religious about, right?), add some strength training. Aim for six to eight moves that target the upper and lower body. Choose a weight you can lift no more than 8 to 12 times. If weights aren't your cup of tea, try Pilates, swimming, or power yoga—all of which will give you toned, firm, and shapely muscles.[pagebreak]

Trim Belly Fat

What do a skinless chicken breast, a good night's sleep, and a half-hour of yoga have in common? All can help whittle your waistline. Scientists are discovering that during stress, abdominal fat cells absorb more fat than usual. The result: You start leaving your shirttails out. The following weight loss strategies can stop stomach spread.

Eat (lean) meat. Eating more protein and fewer carbohydrates allowed 23 Danish women and men to shed 10% more belly fat—the dangerous intra-abdominal fat that raises risk for diabetes and heart disease—than dieters whose plates held more sweets and produce, say researchers from the Royal Veterinary and Agricultural University in Copenhagen.

No one's sure why eating fewer carbs and more protein would selectively target belly fat. "We need to do more studies," says researcher Arne Astrup, MD, a nutrition professor at the university. One possible explanation: A higher protein intake may somehow trigger smaller releases of the anxiety hormone cortisol. Cortisol directs the body to store more fat in the abdomen—less cortisol, less belly fat.

Whatever the reason, in the first-ever independent, clinically controlled study of the Atkins diet, researchers at Temple University School of Medicine monitored every calorie eaten and spent by 10 obese men and women with type 2 diabetes. After a week of typical eating, the volunteers followed Atkins for 2 weeks, with carbs limited to 21 g per day (down from an average of 300 g), while they were encouraged to feast from an array of foods including fatty, high-calorie fare. They stayed at the hospital for the duration of the study to ensure exact measurements of calorie intake and expenditure. On average, the volunteers lost 4 pounds—not bad for 14 days.

But in a surprise that bodes well for the patients' future weight loss, they unconsciously trimmed nearly 1,000 calories from their daily intake. The volunteers averaged 3,111 calories a day before they began the diet; they dropped to 2,164 calories on the low-carb regimen. And that magic number of around 2,100 calories per day was exactly the amount of energy they should've been consuming to avoid weight gain, says study author Guenther Boden, MD. "In other words, they self-corrected their excessive appetites down to normal," Boden said.

Try this: Don't skimp on protein—aim for a moderate portion at each meal. High-protein dieters in Astrup's study got 25 of their daily calories from protein—in 1,500-calorie diets, that's just 375 calories (the amount you'd get if you had an egg, a 4-ounce chicken breast, and a hamburger made from 4 ounces of 96% lean ground beef).

Stay calm. If your life could easily be subtitled "The High Anxiety Story," you're setting yourself up for a tummy pooch that's more deadly than cute—even if you're not overeating. Doctors at the University of California, San Francisco have found that chronic stress raises levels of cortisol. In addition to sending extra fat to your midsection, this hormone persuades you to eat more high-fat, high-carb foods when you're feeling stressed, says physiologist Norman Pecoraro, PhD.

Try this: Develop an inner sense of control that allows you to nip stress in the bud so you don't have to snack your way out of it. Meditation and yoga help, but Pecoraro thinks there's a better place to start. "There are some very pragmatic ways to reduce persistent stress that don't involve eating," he says. "Start with active coping—pay the bills!—rather than passive avoidance, such as refusing to open envelopes from your credit-card company."[pagebreak]

Success storiesBe fickle. Nearly all the dieters below took this approach: If the first diet you try doesn't work, it may be a bad fit. Try another. "Mainstream diets may be interchangeable," says Michael L. Dansinger, MD, lead researcher of a study comparing diets at Tufts-New England Medical Center in Boston.

Date your diet. If you get tired of one, you can switch to another. You haven't failed, you just need something different. "You might be attracted to a diet in one way but annoyed in another. There may be physical chemistry but not that emotional bond or vice versa. You need something that works and that you enjoy," says Dansinger. But be patient. "If you're not enjoying your new eating plan during the first month, but you're losing weight and feeling well, stick with it another month," he says. "Many people in our study found it took 2 months before their taste buds changed and they learned how to enjoy their new diet."

Eventually doctors may be able to determine your "diet" type and match you with the right plan. "We're finding that gender, age, family situation, even ethnic background makes a difference," Dansinger says. "Someday you won't be alone in finding the right way to lose weight."

BRITNEY PAULSONPounds Lost: 56

Paulson got easily discouraged when she ate poorly. "I was one of those people whose day had to be perfect foodwise." She joined LA Weight Loss and got regular one-on-one counseling, which helped her gain perspective on her slipups.

KATHRYN BENNETTPounds Lost: 33

Bennett joined the ChangeOne.com diet plan because it had fewer restrictions, but working out was really the secret to her success. "I now exercise 6 days a week, 45 to 60 minutes—even on vacation. I'm such a fan that I'm now an aerobics instructor."

JUDY LEDERMANPounds Lost: 95

Lederman cut nearly all sugar from her diets (except chocolate). She gets her carbs in the form of fruits, soy chips, and other nutrient- and fiber-dense foods. "I follow this religiously, and when I don't, I do extra time on the treadmill."

BARBARA NEUZILPounds lost: 50

"I eat much more than I ever have before," says Neuzil. Strange talk for a successful dieter, but Neuzil used to skip meals. Now she eats all day, snacking on proteins like cheese between meals that deliver more protein. "I feel much more satisfied."

CINDY BONSTEELPounds Lost: 106

Bonsteel tried several diets—Weight Watchers and Slim-Fast, among others—but it wasn't until she read the book Flip the Switch by Jim Karas that she was able to gain the willpower she needed. "It helped me with the excuses. I had to see myself succeeding."